Acute kidney injury (AKI) is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research. We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI. Members representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI participated in a two day conference in Amsterdam, The Netherlands, in September 2005 and were assigned to one of three workgroups. Each group's discussions formed the basis for draft recommendations that were later refined and improved during discussion with the larger group. Dissenting opinions were also noted. The final draft recommendations were circulated to all participants and subsequently agreed upon as the consensus recommendations for this report. Participating societies endorsed the recommendations and agreed to help disseminate the results. The term AKI is proposed to represent the entire spectrum of acute renal failure. Diagnostic criteria for AKI are proposed based on acute alterations in serum creatinine or urine output. A staging system for AKI which reflects quantitative changes in serum creatinine and urine output has been developed. We describe the formation of a multidisciplinary collaborative network focused on AKI. We have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.

Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

https://minerva-access.unimelb.edu.au/bitstream/handle/11343/238777/Global, regional, and national burden of chronic kidney.pdf

Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Transplantation of nonrenal organs is often complicated by chronic renal disease with multifactorial causes. We conducted a population-based cohort analysis to evaluate the incidence of chronic renal failure, risk factors for it, and the associated hazard of death in recipients of nonrenal transplants. Methods Pretransplantation and post-transplantation clinical variables and data from a registry of patients with end-stage renal disease (ESRD) were linked in order to estimate the cumulative incidence of chronic renal failure (defined as a glomerular filtration rate of 29 ml per minute per 1.73 m2 of body-surface area or less or the development of ESRD) and the associated risk of death among 69,321 persons who received nonrenal transplants in the United States between 1990 and 2000. Results During a median follow-up of 36 months, chronic renal failure developed in 11,426 patients (16.5 percent). Of these patients, 3297 (28.9 percent) required maintenance dialysis or renal transplantation. The five-year risk of chronic renal failure varied according to the type of organ transplanted - from 6.9 percent among recipients of heart-lung transplants to 21.3 percent among recipients of intestine transplants. Multivariate analysis indicated that an increased risk of chronic renal failure was associated with increasing age (relative risk per 10-year increment, 1.36; P Conclusions The five-year risk of chronic renal failure after transplantation of a nonrenal organ ranges from 7 to 21 percent, depending on the type of organ transplanted. The occurrence of chronic renal failure among patients with a nonrenal transplant is associated with an increase by a factor of more than four in the risk of death.

/pdf/chronic-renal-failure-after-transplantation-of-a-nonrenal-28y19xje8d.pdf

Chronic renal failure after transplantation of a nonrenal organ.

Worldwide access to treatment for end-stage kidney disease: a systematic review.

CKD in disadvantaged populations: the uncomfortable realities.

CKD in Disadvantaged Populations

Around 850 million people are currently affected by different types of kidney disorders.1 Up to one in 10 adults worldwide has chronic kidney disease (CKD), which is invariably irreversible and mostly progressive. The global burden of CKD is increasing, and CKD is projected to become the fifth most common cause of years of life lost globally by 2040.2 If CKD remains uncontrolled and if the affected person survives the ravages of cardiovascular and other complications of the disease, CKD progresses to end-stage renal disease (ESRD), where life cannot be sustained without dialysis therapy or kidney transplantation. Hence, CKD is a major cause of catastrophic health expenditure.3 The costs of dialysis and transplantation consume 2% to 3% of the annual healthcare budget in high-income countries, and spent on <0.03% of the total population of these countries.4 Importantly, however, kidney disease can be prevented and progression to ESRD can be delayed with appropriate access to basic diagnostics and early treatment including lifestyle modifications and nutritional interventions.4-8 Despite this, access to effective and sustainable kidney care remains highly inequitable across the world, and kidney disease a low health priority in many countries. Kidney disease is crucially missing from the international agenda for global health. Notably absent from the impact indicators for the Sustainable Development Goal Goal 3. Target 3.4: “By 2030, reduce by one third premature mortality from non-communicable diseases (NCDs) through prevention and treatment and promote mental health and well-being” and from the latest iteration of the United Nations Political Declaration on NCDs, kidney diseases urgently need to be given political attention, priority, and consideration.9 Current global political commitments on NCDs focus largely on four main diseases: cardiovascular disease (CVD), cancer, diabetes, and chronic respiratory diseases. Yet, it is estimated that 55% of the global NCD burden is attributed to diseases outside of this group.10 Furthermore, kidney disease frequently co-exists with one or more of the above four major NCDs, leading to worse health outcomes. Chronic kidney disease is a major risk factor for heart disease and cardiac death, as well as for infections such as tuberculosis, and is a major complication of other preventable and treatable conditions including diabetes, hypertension, human immunodeficiency virus, and hepatitis.4-7 As the Sustainable Development Goals and Universal Editorial

/pdf/kidney-health-for-everyone-everywhere-from-prevention-to-h3wsvqbj3i.pdf

Kidney health for everyone everywhere-from prevention to detection and equitable access to care.

Kidney disease and poverty in disadvantaged populations.

La brucelosis es una infección zoonótica con alta incidencia en México. La afectación de Brucella se inicia en el sistema reticuloendotelial, con diseminación al bazo, al hígado, al riñón, al sistema nervioso central y a la médula ósea. La afectación renal en la brucelosis no es común, cerca del 3%. La nefropatía asociada a brucelosis se clasifica en 3 tipos: nefritis intersticial aguda, forma crónica con la formación de granulomas con necrosis caseosa y glomerulonefritis asociada a endocarditis por Brucella. Presentamos el caso de una mujer de 40 años que presenta una glomerulonefritis por Brucella asociada a endocarditis, y una revisión del tema.

Guillermo Garcia-Garcia

Papers

CKD in disadvantaged populations: the uncomfortable realities.

CKD in Disadvantaged Populations

Kidney health for everyone everywhere-from prevention to detection and equitable access to care.

Kidney disease and poverty in disadvantaged populations.

Glomerulonefritis asociada a endocarditis por Brucella. Reporte de un caso y revisión de la literatura